If any of you have experienced anything like this, please respond.  (Don't
respond with basic management suggestions for clogged ducts, nipple blebs,
and yeast infections--we've been there, done that.)  Here's the story:

Mother of a 5 month old has been suffering (for 10 weeks now) from a
recurring clogged duct in the upper inner quadrant of her left breast.
This is the pattern that has revealed itself over time:

There is a constant white or yellowish "bleb" on the tip of her nipple.
It is painless for two days.  On the 3rd day the nipple feels sore.  By
the 4th or 5th day the breast is clogged.  Within 24 hours it clears,
leave some achiness.  Then the cycle repeats itself.

This strong, non-complaining woman is at her wit's end.  She breastfed her
other two children and had a clogged duct once with each of them, IN THE
SAME SPOT, but it never recurred until now.

A breast surgeon familiar with lactation did a mammogram and an ultrasound
which revealed nothing abnormal.  Her caring obstetrician consulted with
another breast disease specialist and a dermatologist.  I went with her on
these consults and the only "diagnosis" that rung a bell for me was the
dermatologist's:  "possible sebaceous cyst."  Treatment would be removal.

Now we have these questions:  When the "block clears" (as she puts it),
she can express clear fluid from the white bleb.  I speculated that it
could be colostrum-like milk, from an area that hasn't been drained for
over 3 days, or it may be sebum from the cyst (I'm stretching my brain,
here).  She is leaning toward letting that breast dry up, or submitting to
surgical removal of the bleb.  Has anyone ever worked with a mom who had
surgery on her nipple during lactation?

Ginna Wall, MN, IBCLC, Lactation Services Coordinator
University of Washington Medical Center, Mailbox 356153
1959 NE Pacific Street, Seattle WA 98195
Voicemail: (206)548-6368, Fax: (206)548-7665